update July 29, 2008

   On Sunday I upped my dosage for metformin from 500mg to 1000mg.  So far the diarrhea has calmed down to a once a day incidence that seems to be moving a little later everyday.  The symptom that’s taken its place is nausea.  It’s like constant morning sickness, but no pregnancy to show for it.  So I’m expecting this symptom to start winding down come Friday, when I have to up my dose again to 1500mg.  Oh, the anticipation to see what side effects that will bring!  The metallic/chemical taste in my mouth has gone away except when I eat chicken.  No more chicken for me for awhile, I think, which sucks because Paul and I love it and have it a few times a week.  Maybe I’ll try turkey and see how I like that.

   In other news, I’m dreading an in-law family party this weekend.  It’s at my FIL and step-MIL’s house, and it’s a combination 4^th of July/birthday/graduation/going-away party.  My step-MIL has a 4^th of July party every summer, on various weekends that never seem to fall on the actual 4^th.  The birthday/graduation/going-away part is for my step-SIL, who recently turned 18 and graduated from high school.  Next week she leaves for Navy boot camp.  So this party will probably not be as bad as I’m thinking, but you never know.  I’m expecting to have to explain why I’m not drinking (can’t have alcohol with metformin), and I don’t want to give away all my health issues, and everyone (especially step-MIL) will suspect that I’m pregnant if I’m not drinking.  Then of course we’ll get the questions about when we’re going to have kids.  (Mental note: talk to Paul about this to make sure we’re on the same page with our answers.)  Now that we’ve been married almost a year, this question is starting to come up.  There’s never a right answer to that question, unless it’s your mother or your best friend asking.  No one else needs to know the details, in my opinion.

   My relationship with my in-laws is weird, and my husband’s relationship with his own family is for another post altogether.  Let’s just say for now that Paul doesn’t really get along with his step-mom, or his real mom.  I get along with everyone just fine, but am constantly annoyed by my step-MIL, and am very close to hating my real MIL.  I’m annoyed greatly by both my step-SIL and half-SIL, but I absolutely ADORE my BIL and FIL.  Those are the two people that my husband grew up with and they mean the most to him, so I guess that’s the important part.  I guess I just have to cross my fingers and hope for the best.

Insert cliche here. July 25, 2008

   Things have been okay at work lately.  It helps that we’re slow right now.

   After that last really bad week, I went to my supervisor and talked to her about everything that’s been going on, both at work and in my personal life.  She was incredibly supportive.  (It turns out her daughter struggled with infertility, and recently had a baby by way of IVF.)  My supervisor is so funny; sometimes she’s really harsh and cold, and other times she cries right along with you, so you never know what to expect.  But since her granddaughter was born, and she got married about 2 years ago, and she’s about to retire in a year, she’s mostly pretty nice and happy.

   So anyways, I talked to her, and she agreed to mediate a meeting with my coworker (M), which we had a couple days later, and it went okay.  We both shared things we liked about each other, then discussed what could be worked on.  I found that M was really dismissive with my complaints, and had extremely petty complaints about me.  But things are better now, and will be for another week or so.  But I expect her to start slipping back at some point.  Old habits die hard.  You can’t teach an old dog new tricks.  Etc.

Icky. July 24, 2008

Today’s day 3 of metformin (500 mg/day).  I guess it’s going okay.  I feel, constantly, a general sense of unease in the digestive area.  I’m bloated, gassy, crampy, and uncomfortable.  Everyday, two and a half hours (exactly) after I take the pill, I have diarrhea.  I’ve gone from being (almost) constantly hungry before I started metformin, to never, ever being hungry.  I’m forcing myself to eat at the appropriate times, even if it’s just a little.  I also have a chemical/metallic taste in my mouth in the evenings, which on the first night caused me to throw out the chicken my husband had made for dinner because I thought it had spoiled.  Another interesting side effect is that I seem to have lost 4 pounds between Monday and today, which is very nice, although it could just be a fluke or water-weight.  But water-weight would seem odd, given how ridiculously bloated I am.

Good-bye, my (not so secret) love… July 22, 2008

   I had my appointment with the Reproductive Endocrinologist yesterday.  My mom went with me, because she’s been through this all before, and Paul can’t take a lot of time off work right now (and he wouldn’t have been much help anyways).  The RE was great; she was very nice and listened to my questions.  Her big thing was that I need to lose weight, at least 10%, but she was sure to say how she knew it was difficult because of the insulin resistance.  She asked if I was interested in metformin despite the side effects (diarrhea, loss of appetite, indigestion), and I said yes.  So she prescribed that, which I started this morning.  I am to start with one pill in the morning for 5 days, then add a second pill in the evenings for another 5-7 days, then a 3^rd pill if I can tolerate it.  I’ll let you know how it goes.  She also wants me to get bloodwork done in about 6 weeks to check my liver and kidney function, because a serious side effect is lactic acidosis.

   Step 2 is that she referred me to a nutritionist who specializes in diabetes, PCOS, and insulin resistance.  I need to find out tonight if my insurance will cover it, but I think I’ll go at least once to see what she has to say, even if I have to pay for it myself.  I’m sure she’ll tell me to cut out refined carbs, and eat a lot more whole grains, fruits, and veggies.  I love refined carbs.  I mean, if my husband hadn’t come along when he had, I might have MARRIED refined carbs.  I’m eating chocolate covered pretzels as I write this.  It will be sad, so very sad.

   Another suggestion she had was gastric bypass surgery.  She encouraged me to do some research on it and think about it.  My first instinct is no.  I mean, I’ve thought about it before.  I’m sure anyone who’s even slightly overweight has thought about it.  But I know that it’s no easier (probably even harder) than “traditional” weight loss, and there are the risks, plus I’d be so afraid that I’d lose all the weight only to gain it all back again in a couple years.  Also, she told me that it’s about a 6 month process before the surgery (counseling, dieting, etc), and then they recommend people wait at least a year, preferably two, before trying to conceive.  That would mean I would be 30 before we could even TTC, which is heartbreaking to me, to not even have a chance until then.

   So my plan is to take the metformin unless it kills me, and try desperately to eat better and exercise some more.  Wish me luck.

Vent July 10, 2008

I really can’t stand my co-worker.  I really, really can’t.

   At my company, in my department, we work in teams of two.  That way, if someone’s sick or on vacation, there’s always someone else who knows the accounts and the customers.  My teammate is about two years from retirement, has been with the company for over 20 years, and is under the impression that she never, ever does anything wrong. 

   I do things wrong.  I’ve only worked here for 4 years, and it’s a complicated job with a lot to remember.  I’ve been working with this woman (let’s call her M) for about a year, and she was a culture shock.  The woman I worked with before was laid back, made mistakes, and was able to laugh about them.  I like that.  M acts as though she never makes mistakes.  And if she does, she beats herself up over them, saying things like “I want to go bang my head against a brick wall” or “I can’t believe I was that stupid.”  When I make a mistake, I say “Oops, I’ll try not to do that again” or “Wow, that was pretty silly of me, wasn’t it?”

   When I make a mistake or forget to do something, she uses phrases like “In the future, you need to…” or “FYI…” or “That’s not the way I do it.”  It’s enough to make me scream (or cry).  And when I hear it at least once a day, you’d think I’d try to make fewer mistakes, but instead it just makes me shut down, causing more mistakes.

   M has always been this way.  I have several other coworkers who’ve teamed with M in the past, and they commiserate with me and insist that she’s always been this way, and no matter how much you complain to her or the supervisor or manager about her, she never changes.  I actually haven’t complained too much, because I know she’s not going to change.  I guess I feel like, if I complain just a little, at least they’ll know that she’s still doing it, and that it’s still not okay.

   The past week or so (since the “diagnosis”), I’ve been distracted at work, and rightfully so.  My head just isn’t here.  I also have a few special projections that I’ve been working on, and I think she resents that I have work to do that doesn’t involve her; that I’m not at her beck and call to do whatever she tells me all the time.  But I know that she would actually prefer to work by herself all the time, because it would make her more of a martyr.  To prove my point, just a little while ago she said “Is there any reason why you failed to do blah blah blah?  You really need to remember to do that in the future.  You should know better.”

   She’s just mean.  And I’m sensitive lately.  Cut me some slack, lady.

And the winner is… July 8, 2008

   Last Tuesday I had an appointment with my doctor to go over my bloodwork results.  The progesterone levels indicated that I hadn’t ovulated, and were actually a little low even for that.  She said I might need to supplement with progesterone when I do get pregnant.

   Almost everything else was okay, including my cholesterol, prolactin, and thyroid levels.  What wasn’t okay was my insulin.  I was showing as slightly insulin-resistant, which is a big marker for PCOS.  And while she never used the term PCOS herself, she didn’t disagree with me when I brought it up, and said she wanted to start me on metformin because most women get pregnant within a couple months of starting it, and refer me to a RE.  When I told her that we weren’t technically TTC until September, she changed her mind.  Instead, she referred me straight to a RE at the big hospital.  That appointment is now scheduled for 2 weeks from today.

   The receptionist at the RE’s office was confused as to why I was coming in, so I had to explain everything to her, even though I was at work.  I thought my doctor’s office was supposed to include that information in the referral paperwork?

   So now I have the appointment to look forward to, and don’t have much idea what to expect.  Maybe an ultrasound?  Probably a metformin prescription?

   The reason it took me so long to post was that I was trying to process this information.  I’ve suspected PCOS for about a year now (which was why I went off the Pill so early before TCC), but it’s different to pretty much know that’s what’s wrong with me.  I’ve been pretty touchy this whole week, falling to tears with barely a nudge.  My mom has been too.  She said she just wishes that I didn’t have to go through this.  She did, and it sucked, and even though it’s come a long way since then, it’s still not good.

   I sat down with Paul and explained the situation.  His first comment was “how can the ovaries cause all that damage?”  I explained that the ovaries were really just a side-effect, and gave him definitions on insulin-resistance, diabetes, etc, and told him about metformin and Clomid and such.  He seemed to understand, but I know he doesn’t understand the seriousness of it, although he did ask about long-term effects (diabetes, heart disease, high cholesterol, cancer), so that was nice of him.  I’m pretty sure he still thinks getting pregnant will be as easy as unprotected sex at the right moment.  And it could be.  The problem is getting that right moment, because I’m not ovulating.